High street retail environment interventions and their theorised impacts on health and wellbeing: A scoping review.

Health outcomes are influenced by social and environmental determinants of health. As places where people work, live, meet and consume, high street retail environments are influential in shaping health. In recent decades, high streets have been in decline, prompting policies to revitalise retail environments and support local businesses, particularly in European and North American countries. The aim of this scoping review was to systematically map evidence on retail environment interventions, to gain a deeper understanding of the current evidence base assessing their possible health and wellbeing impacts. The objectives were to identify different types of interventions and the outcomes they address; and the mechanism through which interventions are theorised to influence health and equity. Peer-reviewed studies were identified through academic databases (MEDLINE, Embase, EconLit, Web of Science and Social Policy and Practice) using relevant search terms. Additional (grey) literature was identified using citation scanning and online searches. Studies were eligible if they evaluated interventions with a significant focus on supporting the retail environment, reported on at least one health and wellbeing outcome and were written in English. Relevant data were extracted and presented descriptively. An interpretive approach was taken to analyse theories of change. The searches identified 53 peer-reviewed studies and nine grey literature reports. Interventions were categorised as follows: area-based initiatives, business improvement districts, business incentives, and demand-side incentives. Studies predominantly evaluated impacts on social and environmental determinants of health. Some studies measured impacts on self-rated (mental) health, physical activity and food consumption and purchasing. Studies reported evidence of both improved and worsening outcomes. Theories of change were often under-specified and reductionist, lacking a clear understanding of the complex systems in which interventions take place. Future interventions could benefit from more comprehensive theories of change that meaningfully integrate economic, and health and wellbeing outcomes. This requires intersectoral collaboration.